Individual provider Active NPI

Kurosh A. Safavi, MD

  • Diagnostic Radiology Physician
  • Gretna, LA
National Provider Identifier
1083805113
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD199928 Issued in LA
Practice address
2500 Belle Chasse Highway
Gretna, LA 70056
Phone
(504) 391-5177
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 199928 LA
Diagnostic Radiology Physician 2085R0202X 38008 AZ
Diagnostic Radiology Physician 2085R0202X MD199928 LA Primary

Addresses

Primary practice location

2500 Belle Chasse Highway
Gretna, LA 70056

Mailing address

1514 Jefferson Highway
New Orleans, LA 70121
Phone (504) 842-4000

Other identifiers 3

IdentifierTypeStateIssuer
P00625182OtherAZRAILROAD MEDICARE
1058629MedicaidLA
350275MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080811000219 AZ Practitioner - Diagnostic Radiology 4688748502
I20090707000026 LA Practitioner - Diagnostic Radiology 4688748502 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38008AZMDDiagnostic Radiology Physician
199928LAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Jul 1, 2009 Accepting new patients
Lallie Kemp Medical Ctr CurrentSince Dec 22, 2021 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Sep 7, 2021 Accepting new patients
Ochsner Clinic LLC CurrentSince Jul 1, 2009 Accepting new patients
Louisiana State University School of Medicine in New Orleans Faculty G CurrentSince Sep 7, 2021 Accepting new patients
Lallie Kemp Medical Ctr CurrentSince Dec 22, 2021 Accepting new patients
Ochsner Clinic LLC Current Accepting new patients

Locations

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

52579 Highway 51 S
Independence, LA 70443
Phone (985) 878-1349

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

1542 Tulane Ave
New Orleans, LA 70112
Phone (504) 866-2741

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

2500 Belle Chasse Hwy
Terrytown, LA 70056
Phone (504) 391-5157

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1083805113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HIGHWAY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70121",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 BELLE CHASSE HIGHWAY",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "70056",
            "telephone_number": "504-391-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFAVI",
        "first_name": "KUROSH",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": "199928",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "38008",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "LA",
            "license": "MD199928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00625182",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1058629",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "350275",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gretna, LA

Sources for this page

Verify at the official NPI Registry.